Predicting trends in operative delivery for cephalopelvic disproportion in Africa

The Lancet ◽  
1990 ◽  
Vol 335 (8693) ◽  
pp. 861-862 ◽  
Author(s):  
KelseyA. Harrison
Author(s):  
Deirdre J. Murphy

Normal labour involves an appropriate-sized fetus in a vertex presentation with a well-flexed head that descends and rotates within the maternal pelvis in response to uterine contractions, delivering in an occipitoanterior position. Abnormal labour occurs when any one or a combination of these factors deviates from normal. It may involve a malpresentation (e.g. face, brow, or breech), a malposition (e.g. occipitoposterior), or cephalopelvic disproportion. The consequences include prolonged labour, obstructed labour, operative vaginal delivery, or caesarean section. Appropriate management requires expertise in clinical assessment, decision-making, and the technical and non-technical skills of operative delivery. A systematic approach is required including an awareness of risk factors for abnormal labour, early identification of deviations from normal, use of preventative strategies where possible, and appropriate intervention when necessary. Good teamwork and clear communication between midwives and obstetricians is essential within a labour ward setting. Timely transfer may be required in a homebirth setting. Particular skills are required in low-resource settings where obstructed labour may be advanced at the time of presentation.


2008 ◽  
Vol 68 (S 01) ◽  
Author(s):  
MS Lenhard ◽  
T Johnson ◽  
S Weckbach ◽  
K Nikolaou ◽  
K Friese ◽  
...  

1970 ◽  
Vol 7 (1) ◽  
pp. 25-28 ◽  
Author(s):  
M Jha

Background: The main aim of this study is to determine the maternal and fetal outcome of pregnancy among women with one previous caesarean section at term in relation to vaginal delivery, post partum complication, neonatal complication like low Apgar score, fetal weight and admission in special baby unit. Methods: This is a prospective and descriptive study done in a sample size of 100. Inclusion criteria were term pregnancy, single live fetus with cephalic presentation with one previous caesarean section. During study period total number of obstetric admissions was 3546 and 115 cases were admitted with previous one caesarean section. Result: Out of 100 cases, 31 cases had vaginal delivery and 69 cases had caesarean section. Among 31 vaginal deliveries, 24 cases had spontaneous vaginal delivery and 7 had assisted delivery with vacuum, main indication of vacuum delivery was to cut short the second stage of labor that was in 5(71.43%) cases. Among 69 caesarean section cases, 51 had emergency caesarean section and 18 had elective caesarean section and cephalopelvic disproportion was the main indication in both the groups. Most common complication was scar dehiscence and postpartum hemorrhage. There were two still births in each group and one minute APGAR score was slightly better in caesarean section. Conclusions: Patients with previous caesarean section are at high risk of repeat emergency or elective caesarean section. About one in three patients with previous caesarean section delivered vaginally. In the present study postpartum hemorrhage was the commonest complication, which was found in caesarean section, and only  one puerperal pyrexia was seen in case of vaginal delivery. Key words: Cephalopelvic disproportion, Premature rupture of membrane, Septicemia, Vacuum delivery   DOI: 10.3126/jnhrc.v7i1.2275 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 25-28


2010 ◽  
Vol 284 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Ioannis Kalogiannidis ◽  
Chrysoula Margioula-Siarkou ◽  
Stamatios Petousis ◽  
Michalis Goutzioulis ◽  
Nikos Prapas ◽  
...  

2013 ◽  
Vol 92 (7) ◽  
pp. 809-815 ◽  
Author(s):  
Nils-Halvdan Morken ◽  
Kari Klungsøyr ◽  
Per Magnus ◽  
Rolv Skjaerven

2002 ◽  
Vol 16 (2) ◽  
pp. 115-123 ◽  
Author(s):  
Christine L. Roberts ◽  
Charles S. Algert ◽  
Michelle Carnegie ◽  
Brian Peat

2021 ◽  
pp. 1-9
Author(s):  
Nieves L. González González ◽  
Enrique González Dávila ◽  
Agustina González Martín ◽  
Erika Padrón ◽  
José Ángel García Hernández

<b><i>Objective:</i></b> The aim of the study was to determine if customized fetal growth charts developed excluding obese and underweight mothers (CC<sub>(18.5–25)</sub>) are better than customized curves (CC) at identifying pregnancies at risk of perinatal morbidity. <b><i>Material and Methods:</i></b> Data from 20,331 infants were used to construct CC and from 11,604 for CC<sub>(18.5–25)</sub>, after excluding the cases with abnormal maternal BMI. The 2 models were applied to 27,507 newborns and the perinatal outcomes were compared between large for gestational age (LGA) or small for gestational age (SGA) according to each model. Logistic regression was used to calculate the OR of outcomes by the group, with gestational age (GA) as covariable. The confidence intervals of pH were calculated by analysis of covariance. <b><i>Results:</i></b> The rate of cesarean and cephalopelvic disproportion (CPD) were higher in LGA<sub>only by CC</sub><sub><sub>(18.5−25)</sub></sub> than in LGA<sub>only by CC</sub>. In SGA<sub>only by CC</sub><sub><sub>(18.5−25)</sub></sub>, neonatal intensive care unit (NICU) and perinatal mortality rates were higher than in SGA<sub>only by CC</sub>. Adverse outcomes rate was higher in LGA<sub>only by CC</sub><sub><sub>(18.5−25)</sub></sub> than in LGA<sub>only by CC</sub> (21.6%; OR = 1.61, [1.34–193]) vs. (13.5%; OR = 0.84, [0.66–1.07]), and in SGA <sub>only by CC</sub><sub><sub>(18.5−25)</sub></sub> than in SGA<sub>only by CC</sub> (9.6%; OR = 1.62, [1.25–2.10] vs. 6.3%; OR = 1.18, [0.85–1.66]). <b><i>Conclusion:</i></b> The use of CC<sub>(18.5–25)</sub> allows a more accurate identification of LGA and SGA infants at risk of perinatal morbidity than conventional CC. This benefit increase and decrease, respectively, with GA.


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